Healthcare Provider Details

I. General information

NPI: 1033885645
Provider Name (Legal Business Name): AVP CLINICAL BUSINESS CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2021
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2303 N BROAD ST STE 1
COLMAR PA
18915-9786
US

IV. Provider business mailing address

2303 N BROAD ST STE 1
COLMAR PA
18915-9786
US

V. Phone/Fax

Practice location:
  • Phone: 215-939-0846
  • Fax:
Mailing address:
  • Phone: 215-939-0846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: AKEA WILLIAMS
Title or Position: DIRECTOR
Credential: LPC
Phone: 215-939-0846